Call:
614-568-7297
Home
About Us
Location & Hours
Meet The Team
Testimonials
Services
Wellness Plans
Online Pharmacy
Client Center
New Clients
Payment Options
Blog
Tour
Employment
Videos
Forms
Feline Behavioral Questionnaire
Dog Behavior Questionnaire
Prescription Refill
Appointment Policy
Join Our Team
Contact
Appointment
Select Page
Feline Behavior Questionnaire
Owner's Name
(Required)
First
Last
Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Preferred Phone
(Required)
All Family Members who live at home, including yourself (Name/Age/Occupation)
(Required)
Your Veterinarian’s Name
(Required)
Your Veterinary Hospital’s Name
(Required)
Your Vet’s Address
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Telephone Number
(Required)
Fax Number
Approximate Date of Last Veterinary Visit:
(Required)
MM slash DD slash YYYY
Have you owned a cat before?
(Required)
Yes
No
If yes, was it this breed before?
(Required)
Please list other current household pets: (Name/ Species (dog/cat/etc)/ Breed/ Age/ Sex/ Neuter Status)
Patient Details
Cat’s Name
(Required)
Cat’s Breed
(Required)
Sex
(Required)
Female
Male
Is your cat neutered/spayed?
(Required)
Yes
No
If yes, at what age was this done?
Cat’s Date of Birth
(Required)
MM slash DD slash YYYY
Where did you get your cat?
(Required)
Were you told of previous behavioral problems?
(Required)
How old was your cat when you obtained him/her?
(Required)
How long have you owned your cat?
(Required)
Reason for obtaining this pet
(Required)
How old was your cat when it was weaned?
(Required)
Where was your cat raised?
(Required)
Indoors
Outdoors
What is your cat currently?
(Required)
Indoors
Outdoors
Indoor & Outdoor
Is your cat declawed?
(Required)
Yes
No
If so, which paws:
Front
All four
Medical History:
Please give a brief medical history, including any recurring problems/treatments. Use additional sheets if needed.
Do you know anything about your cat’s parents (ie. any behavioral or medical problems):
(Required)
Check if your pet recently has had:
(Required)
Blood testing
Urine testing
When was the last de-worming?
(Required)
Has your cat been treated for intestinal parasites and when?
(Required)
Is your pet current on its vaccinations?
(Required)
What flea and heartworm medication is your pet on?
(Required)
Was it used all year round? If not, which months is it used?
(Required)
Is your pet current on its vaccinations?
(Required)
Has your cat been on medication for behavior at any time?
(Required)
Yes
No
If yes, please list drug and dosage:
If yes, is your pet on any medications or supplements currently- which ones:
Environment:
What type of home do you live in?
(Required)
House
Apartment
Town House/Condo
Estimate of home’s square footage:
(Required)
How many rooms:
(Required)
Which rooms does your cat have access to?
(Required)
Where does each family member spend most of his/her time?
(Required)
What toys does your cat play with?
(Required)
How often do you change the old toys for new ones?
(Required)
Is a scratching post provided?
Yes
No
If yes, please describe
Is the post used?
(Required)
Often
Occasionally
Rarely
Never
*Please submit a drawn map of your house at the consult and include windows, doors, cat beds, perches, scratching posts, litterboxes, toys, bowls, plants, furniture, resting places, locations of conflict, sites of inappropriate elimination, and any other relevant details.
Cat Husbandry:
Please list the 5 things your pet enjoys most (foods, toys, activities, etc):
(Required)
What type (wet/dry) & brand of food do you give your cat?
(Required)
How much does he/she eat a day?
(Required)
When was the last time you changed your cat’s diet in any way and how did you change it?
(Required)
When & where do you feed your cat each day?
(Required)
Does your cat eat:
(Required)
Quickly
Slowly
Do you have to be present to eat?
(Required)
Yes
No
Does your pet eat meals or nibbles throughout the day?
(Required)
Who feeds your cat?
(Required)
What are your pet’s favorite foods?
(Required)
How often do you change the water?
(Required)
How often do you clean the food & water dishes and how?
(Required)
Do you feel that your pet drinks an excessive amount of water?
(Required)
Where is the litter box located & how many are there?
(Required)
What are the types, shapes & sizes of litter boxes?
(Required)
How often does it empty it's bladder and bowels daily?
(Required)
What type of litter material is used (brand, scent, clay/clump, additives)?
(Required)
Do you always use the same brand?
(Required)
Yes
No
How often is the litter box(s) cleared of waste material?
(Required)
How often is the litter box(s) dumped and washed (with what)?
(Required)
Have you changed the litter or cleaners used (and when)?
(Required)
What cleaners do you use?
(Required)
Does your pet ever eliminate outside the litter box?
(Required)
Yes
No
Inappropriate Elimination:
How often does your cat use the litter box?
(Required)
The litter box is used for:
(Required)
Urine only
Feces only
Neither
Both
Does your pet bury its urine?
(Required)
Always
Usually
Occasionally
Rarely
Never
Don’t Know
Does your pet bury its feces?
(Required)
Always
Usually
Occasionally
Rarely
Never
Don’t Know
Does your pet dig and scratch around the litter box?
(Required)
Yes
No
Inappropriate elimination:
(Required)
Urine
Feces
Both
How often does this occur:
(Required)
Always
Daily
Weekly
Monthly
Other
If other, please specify
What time of day do you usually find it?
(Required)
Have you ever witnessed this?
(Required)
Yes
No
If yes, your reaction:
What is the posture when depositing urine outside the box:
(Required)
Squatting
Standing
Where is the urine located?
(Required)
List the room(s), locations within them, number of spots found in the room and other details:
Has there been a change in litter box location?
(Required)
Yes
No
If yes, from where to where and when?
(Required)
Has there been a change in litter type?
(Required)
Yes
No
If yes, from where to where and when?
(Required)
Interactions:
Is your cat protective around its body (stiffens, growls, scratches or bites)?
(Required)
Does your pet ever show inappropriate mounting or sexual activity?
(Required)
Yes
No
If yes, describe:
If other cats present, how do they interact?
(Required)
How does your pet behave towards familiar vs. unfamiliar animals in the home?
(Required)
Do you ever see cats in your yard?
(Required)
Daily
Weekly
Monthly
Never
Is your cat agitated by their presence?
(Required)
Yes
No
Describe
Does your cat defend its territory against these cats?
(Required)
Yes
No
N/A
How does your pet react to other animals (ie. squirrels, birds, etc)?
(Required)
Does your cat catch prey?
(Required)
Yes
No
If yes, is it:
(Required)
Occasionally
Regularly
What type of prey does it catch?
(Required)
How does your pet behave when visitors come to your home (ie. hides, interested, aggressive)?
(Required)
Is the behavior different between strangers and familiar people?
(Required)
Is the behavior different between men, women or children?
(Required)
Please list any regular visitors to the home, the purpose of the visit, frequency, cat’s reaction:
24 Hour “Day In the Life”:
Starting when the earliest family member gets up, detail who feeds and when, where the cat resides, when play occurs, when attention is given, when other animals interact with it, when food is actually eaten, when house is totally quiet, when it is alone and when behavior problems often occur.
4 AM
5 AM
6 AM
7 AM
8 AM
9 AM
10 AM
11 AM
12 PM
1 PM
2 PM
3 PM
4 PM
5 PM
6 PM
7 PM
8 PM
9 PM
10 PM
11 PM
12 AM
1 AM
2 AM
3 AM
Routine
Where does your pet sleep? AM and PM
(Required)
Does your pet ever wake you at night?
(Required)
Yes
No
If yes, why and how often?
Does your pet seek out high places (& where):
(Required)
When does your cat go outside and for how long (summer vs. winter)? If yes, through a cat door or controlled?
(Required)
What type of fencing is used to restrain your pet?
(Required)
Check if your pet is keen to explore on its own
(Required)
Yes
No
Check if there a specific time devoted to play or training daily
(Required)
Yes
No
Check if your pet plays games with any family members?
(Required)
Yes
No
Please describe:
Who initiates the play:
(Required)
People
Pet
What types of toys are involved?
(Required)
Does your pet ‘come’ or have any tricks (describe)?
(Required)
Where does your pet stay when no one is home?
(Required)
How long is your pet alone daily?
(Required)
What arrangements are made for your pet if away on vacation?
(Required)
Does your pet get protective over any parts of his/her body (ie. ears, feet)? If yes, where?
Check if your pet licks or chews itself more than you would expect?
(Required)
Yes
No
Describe if you avoid grooming or other ‘maintenance’ work with you cat due to its behavior?
Has your household changed since acquiring your pet?
(Required)
Death of a pet
Death of family member
Illness
Divorce
Marriage
New baby
College-bound child
Schedule change
Pet added
Other
If other, please specify
Aggression: **Please answer the questions below if the problem is aggression-related.**
Has your cat ever bitten/scratched a person? If yes, did it break skin?
Describe the incident in detail (who/when/where/ person’s response):
Did the person required medical treatment? (Hospital, Antibiotics, or Sutures)
(Required)
Was the bite reported to the authorities?
Has your cat ever bitten/scratched an animal? If yes, did it break skin?
Describe the incident in detail (who/when/where/ person’s response):
Did the animal required medical treatment? (Vet Clinic, Antibiotics, or Sutures)
(Required)
Please list types of aggression (Growl, Swats, Scratches, Bite) with the following:
Handling/Grooming:
Petting/Hugging:
Disturbed when Resting:
Disciplining:
Taking away Objects:
Taking away Food:
With another household animal:
Other:
Please list with whom aggression has occurred (owner- male/female, children-age, others):
Handling/Grooming:
Petting/Hugging:
Disturbed when Resting:
Disciplining:
Taking away things:
Other:
Current Problems:
Describe what your cat is doing that is a problem to you?
(Required)
When did it begin (month/season)?
(Required)
How long has it been present?
(Required)
Where does the problem occur?
(Required)
With whom?
(Required)
How often?
(Required)
Did the onset of the problem coincide with any event/action?
(Required)
How do you correct your cat when he/she misbehaves?
(Required)
Other details?
(Required)
Describe the most recent incident: (time of day/date, who was involved, location, where was everyone in relation to the cat, what happened before the incident, what did the cat do, describe the cat’s body posture, how everyone responded, how did the cat respond to this)
Describe the second most recent incident: (time of day/date, who was involved, location, where was everyone in relation to the cat, what happened before the incident, what did the cat do, describe the cat’s body posture, how everyone responded, how did the cat respond to this)
Describe the third most recent incident: (time of day/date, who was involved, location, where was everyone in relation to the cat, what happened before the incident, what did the cat do, describe the cat’s body posture, how everyone responded, how did the cat respond to this)
Describe the third most recent incident: (time of day/date, who was involved, location, where was everyone in relation to the cat, what happened before the incident, what did the cat do, describe the cat’s body posture, how everyone responded, how did the cat respond to this)
How frequently does the problem occur?
(Required)
times per day
times per month
times per week
times per year
Does the problem(s) occur when you are away from home? If not, where are you and where is the cat when it occurs?
(Required)
Describe everything that has been done to correct the problem(s). Include approx. dates, how long it was tried and how well your cat responded.
(Required)
Is the problem getting:
(Required)
Better
Worse
No Change
Do you suspect a cause?
(Required)
You and Your Pet:
How would you describe your relationship with this pet?
Adult owners (female):
Adult owners (males):
Children:
What are your feelings about the cat’s present behavior?
Adult owners (female):
Adult owners (male):
Children:
*The following questions DO NOT mean we are recommending this.*
Under what circumstances would you consider euthanasia?
Have you consider finding a new home for your cat?
Yes
No
If yes, why have you not done so yet?
Is there anything else you would like to add about your cat and its behavior?
What other behaviors does your cat engage in that are objectionable to you?
What are your expectations for change?
Questionnaire complete by:
(Required)
Date
(Required)
MM slash DD slash YYYY